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Cher, of 20d 1 � � (20%uanterra <br /> Custody Record - <br /> G� Environmental <br /> Services <br /> OUA-4149 <br /> Client Project Manager oats Chain Of Cusioody NuSmbee�r <br /> SSC4R 14TERhA4I Au 01 TCDD BROWN <br /> Address Telephone Number(Area Code)/Fax Number Lab Number <br /> 1714 34CC ST MI, qlb-456 4313 U? 910 45b 9113 C6 O; F,43 Page { of <br /> City Stale Zip Code Site Contact Analysts <br /> D CRANERTO C§ 95316 TODD BROWN 916 356-4333 y q T <br /> Project Name Carner/Waybill Number <br /> T T P <br /> 75743 +' a10CI�TGR FEDERAL EgPRESS t E B H <br /> ContracVPurchase Order/Ouote No <br /> g E <br /> OV79 W hs PACK IN W9V ICEISHIP 10 OUANTERPA AUSTIN r, <br /> Sample 10 No and Description Date Time Sample Type Total Containers preservallve Condition on Receipt <br /> Volume Type No <br /> 40 81, GL158P HC! 0 S t 1 g A <br /> DIIPLIfAT$ WATEP 40 N1, GL,SEP HCI T y g <br /> TRIP BLANK It WATER 40 NL GLISEP 1 BC1 g 1 g <br /> Special Instructions <br /> Passible Hazard Identification y mole Disposal <br /> Non Hazard 11713 <br /> Flammable ❑Skin Imtant ❑Poison a ❑Unknown Retum To Client Disposal By Lab ❑Archive For Months <br /> Tum Around Time Required OC Levet Project Specific(Specify) <br /> LJ Normal ❑Ruh ❑1 ❑n ❑711 <br /> I Relinquished fnU�`A D �JlvtBy <br /> e T7me t a r` Time <br /> 3a 5 I c <br /> 2 Relinquished By ✓ Date Time 2 Received By Dale Time <br /> 3 Relinquished By Date Time 3 Received By Date Time <br /> Cgmment5 <br /> DISTRIBO WHITE Stays with Sample CANARY Returned to Client with Report PINK Field Cole I <br />